HomeMy WebLinkAboutGembusia, Denise - 2015 2nd Friday Pre-Primary Commonwealth of Pennsylvania 3
PAGE 1 OF
CAMPAIGN FINANCE REPORT (COVER PAGE)
(NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification , Report , CANDIDATE 1.`� COMMITTEE 2 LOBBYIST 3
Number: Filed By:
Name of Filing Committee, Candidate or Lobbyist:
Street Address:
I 9 0'Z �r leti �w II
City: State. Zip Code:
C(A 1,1 1 -
TYPE OF STH TUESDAY 1. 2ND FRIDAY 2 30 DAY 3' AMENDMENT YES NO.
REPORT PRE-PRIMARY PRE-PRIMARY. POST PRIMARY REPORT?
6TH TUESDAY 4. +.2ND FRIDAY 5' 30 DAY 6' TERMINATION
(place X to PRE-ELECTION PRE-ELECTION POST ELECTION REPORT? . .YES NO
the right ofANNUAL 7. YEARFILING METHOD
report type) REPORT- a ) CHECKONE 11011" PAPER DISKETTE
Name of Office Sought by Candidate: r • • District Office Party County
Number Code Code Code
MO' DAY YEAR �
( Uynhe/(Cfn0f (aun� L ��as��( 5 01IRFP c) i
J �� J L) (SEE INSTRUCTIONS FOR CODES)
FOR .OFFICEUSE ONLY
Summary of Receipts Mo. ..DAY YEAR MO. :DAY YEAR
and Expenditures from: , o ( f 5 To
A. Amount Brought Forward From Last Report $
S. Total Monetary Contributions and Receipts (From Schedule 1) $
C. Total Funds Available (Sum of Lines A and B) $ -
D. Total Expenditures (From Schedule III) $ `
E. Ending Cash Balance (Subtract Line D from Line C) $
F. Value of In Kind Contributions Received (From Schedule Ip $ r.
G. Unpaid Debts and Obligations (From Schedule IV) $
AFFIDAVIT
PART I - If this is a Committee report. treasurer sign here. If this is a Candidate report,.candidate sign here.
I swear (or affirm) that this report, including the attached schedules, on paper or computer diskette, are to the best of my knowledge and belief true,
correct and complete.
Sworn to1 ta��.nsd subscribed before me this
T!1 day of �M(k\a 20 l�•IX+n.'v�`^2l �1c Y/ ' ia✓
,tea eture of Person Submitting Report
�y�p���gr�"r�a ���Ei'Y1�'?ULSI
OFMW A% Printed Name
MY n expo BEAL
WJJL� yt - ���
BETHANY SALHNtULO DAV YR. Area Cod Da�phone Number
PART II - ' stbd OJr 8,fWddidat 's Authorized Committee, candidate shall sign here: - -
I swe o the best of my knowledge and belief this political committee has not violated any provisions of the Act of June 3, 1937
(P-L. 1333, No. 320) as amended.
Sworn to and subscribed before me this
day of 20
Signature of Candidate
Signature Printed Name
My commission expires
MO. DAY VR. Area Code Daytime Telephone Number
Department of State • Bureau of Commissions, Elections and Legislation
303 North Office Building • Harrisburg, PA 17120-0029 • (717) 787-5280
DSEB-E02 (7-99)
PAGE OF .J
SCHEDULE III
STATEMENT OF EXPENDITURES
Name off��Fiiling Committee or Candidate Reporting Period
1 e h l sc C e mig S 1 From / / /Jr To �(
To Whom Paid M0. OAy YEAR mount
O ' i S /S .G
Mailing Address Description of Expenditure
City State Zip Code (Plus 4) t
VY16un}
To Whom Paitl MO. DAY YEAR mount
�Ci a 5 5. rr
Mailing Address Description of Expenditure
Noble l3l VC;
City State Zip Code (Plus 4)
Ca r 6 5(e 013 - (s
To Whom Paid M0. DAY. YEAR mount
C'o v✓t P lei /3 ureav a / . (DO
Meilin Atltlress Description of Expentlitura
Go ► 9- h u .4e a
ity State Zip Code (Plus 4)
Ca / lisle P -10/?;-
To Whom Paid Mo. DAY YEAR jAmount
0L i ( Cis �$ .
Mailing Atltlress Description of Expenditure
1 St S 1 +eP f1
City State Zip Code (Plus 4) P2 I
co rl r51'� PA 1 l0( - e- r0r)O(rn1iser /h«, rLky
To Whom Paid Mo. :DAY YEAR.'r. mount
oS-�
Mailing Address Desc iption of Expenditure �^
t l) Y y
C'tr /�, State Zip Code (Plus 4) ,
l rt0-)n /� 14C65 — I71C71�1 t`I�':j
To Whom Paid MO. 'DAY YEAR mount
( a. s
Mailing Address Description of Expenditure
a55 5. a. S /er
City State Zip Code (Plus 4)
Cdr lis PA 1 170/ - FuncQra
To Whom Paidc� MD. DAY YEAR"` mountt
I l)QSd / "lJfrt( S / c
Mailing Address Desefiption of Expenditure
5 103 Cck,,-(i, i {�(
City State Zip Code (Plus 4)
Y)l-a Cita t-6 CS - Vo nd
To Whom Paid M0. DAY Ni
YEAR JAMOUnt6
Mailing Address Description of Expenditure
o / fa
itY State Zip Coda (Plus 4)
C'a ' 1"SIR /zA /S - S��IQnC aud-jjry
PAGE TOTAL
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D. $ Cj a 36
DSEB-502 (7-99)
PAGE 3 OF
SCHEDULE III
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period CC
QVI�SI C eYVt�QU'ji 2{ From I To J
;14
To Whom Laid MO. DAY YEAR - moU t
^Jorn(✓� �v, $�
Mailing Addicts Description o Expentliture
5 �)o� �a� 1�s14 Plke �� v� 2
city state Zip Code (Plus 4)
r4dxkli � o To Whom Paid M I DAY I YEAR JAmount
Mailin dtlress Description of E entliture�
1� iwt I'� ►2oa�� r
city I State Zip Code (Plus 4)
ulm Kill P►� I II To Whom Paid M0. QAY YEAR-,.'I Amount
'U41e 3
Mailing Address Descriptio of Expenditure
li 1'IVC G�
city State -ZIP Cotle (P us 4)
C Moe
Q
To Whom P ' Pr M0. -DAY -YEAR m115 OU)t
�7 0_)I
I
Mailing Address I Description of xpenditure
y o P01101
15; "7
City State QQZip Code (Plus 4)
I )�
To Whom Paid - MO. .:DAY YEAR;< mount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid rMO. -DAY YEAR'. mount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid "MO.. <DAY. YEAR mount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid MO. DAY YE AR Amount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
PAGE TOTAL
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D. $
DSEB-501 (7-99)